title: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK.
abstract: OBJECTIVE
  To evaluate the risk of aortic aneurysm in patients with giant cell arteritis (GCA) compared with age-, gender- and location-matched controls.
  
  
  METHODS
  A UK General Practice Research Database (GPRD) parallel cohort study of 6999 patients with GCA and 41 994 controls, matched on location, age and gender, was carried out. A competing risk model using aortic aneurysm as the primary outcome and non-aortic-aneurysm-related death as the competing risk was used to determine the relative risk (subhazard ratio) between non-GCA and GCA subjects, after adjustment for cardiovascular risk factors.
  
  
  RESULTS
  Comparing the GCA cohort with the non-GCA cohort, the adjusted subhazard ratio (95% CI) for aortic aneurysm was 1.92 (1.52 to 2.41). Significant predictors of aortic aneurysm were being an ex-smoker (2.64 (2.03 to 3.43)) or a current smoker (3.37 (2.61 to 4.37)), previously taking antihypertensive drugs (1.57 (1.23 to 2.01)) and a history of diabetes (0.32 (0.19 to 0.56)) or cardiovascular disease (1.98 (1.50 to 2.63)). In a multivariate model of the GCA cohort, male gender (2.10 (1.38 to 3.19)), ex-smoker (2.20 (1.22 to 3.98)), current smoker (3.79 (2.20 to 6.53)), previous antihypertensive drugs (1.62 (1.00 to 2.61)) and diabetes (0.19 (0.05 to 0.77)) were significant predictors of aortic aneurysm.
  
  
  CONCLUSIONS
  Patients with GCA have a twofold increased risk of aortic aneurysm, and this should be considered within the range of other risk factors including male gender, age and smoking. A separate screening programme is not indicated. The protective effect of diabetes in the development of aortic aneurysms in patients with GCA is also demonstrated.
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Robson
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Kiran
authors.affiliation: Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Maskell
authors.affiliation: Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine Room, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hutchings
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Arden
authors.affiliation: Department of Rheumatology, Southend University Hospital NHS Trust, Westcliff-on-sea, UK.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Dasgupta
authors.affiliation: Primary care diagnostics, University of Exeter Medical School, Exeter, UK.
authors.forename: William
authors.initials: W
authors.lastname: Hamilton
authors.affiliation: Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.
authors.forename: Akan
authors.initials: A
authors.lastname: Emin
authors.affiliation: Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Culliford
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
authors.forename: Raashid A
authors.initials: RA
authors.lastname: Luqmani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D013700:Giant Cell Arteritis / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D013223:Statistics as Topic; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents
keywords: Cardiovascular Disease; Epidemiology; Giant Cell Arteritis